IT WAS a tired old joke that I had heard many times in medical school. But honest to Pete, this is what she said when I asked her what brought her to the hospital: "The bus carried me."

This was not what I wanted to hear. I was an overextended surgical intern, trying to work up all the evening's new admissions. And now I would have to perform a complete history and physical without a chief complaint. By and large, I never had to worry about eliciting the chief complaint from patients because, by the time I saw them, they were already on the OR schedule for surgery the next day. But my patient, Rose, was not on that list.